Anti-malarial chemoprophylaxis

For effective prevention against malaria, travellers should first be aware of the risk of contracting malaria. Adopting measures to prevent being bitten by mosquitoes is still the best and the first line of defense. The preventive measures include wearing long-sleeved clothes and long trousers when going out at night, applying effective insect repellent (containing DEET) over exposed parts of the body, and staying in accommodation with air conditioning or mosquito screens and nets. Clothing and nets impregnated with permethrin will make them more effective in avoiding mosquito bites. Anti-mosquito sprays or insecticide dispensers could also be used indoors. These simple first line measures will help to prevent malaria and other mosquito-borne diseases such as yellow fever, dengue fever and Japanese encephalitis.

There is at present no effective vaccine against malaria. Depending on individual travel itinerary, antimalarial pills may be required. Medications such as atovaquone-proguanil, doxycycline, and mefloquine are commonly used for malaria chemoprophylaxis. The choice of drug depends on the specific malaria species, the patterns of drug resistance in the destination, as well as the traveller’s health and medical history. Travellers should consult a medical practitioner to determine the appropriate medication, dosage and regimen.

Specific information on malaria risk for each country can be found at the World Health Organization website: https://www.who.int/publications/m/item/vaccination-requirements-and-recommendations-for-international-travellers-and-malaria-situation-per-country-2022-edition

For more information issued by the Centre for Health Protection, please refer to the following website:
Health topic – Malaria
Global Malaria Risk Summary

The following drug information is provided for reference only. Travellers should strictly follow the guidance of physician in order to achieve the maximal protective effect offered by antimalarial chemoprophylaxis. If severe adverse effects occur during travel, making it difficult to continue the prophylaxis, the traveller should seek local medical advice.

(1) Chloroquine

This drug should be taken one week before and throughout the journey, then continue for 4 weeks after leaving the area.

Dose : 5mg base per kg once a week

(2) Proguanil (typically used in combination with another antimalarial drug)

This drug should be taken one day before and throughout the journey, then continue for 4 weeks after leaving the area.

Dose: 3mg per kg daily

(3) Mefloquine

This drug should be taken one week before and throughout the journey, then continue for 4 weeks after leaving the area.

Dose : 5mg per kg once a week

(one tablet contains 250mg)

(4) Doxycycline

This drug should be taken one day before and throughout the journey, then continue for 4 weeks after leaving the area.

Dose : 1.5mg salt per kg daily

(5) Atovaquone + Proguanil hydrochloride

This drug should be taken one day before and daily throughout the journey in affected area, then continuing for 7 days after leaving the area.

Adult dose contains 250mg of atovaquone and 100mg of proguanil hydrochloride :

Dose : >40kg, 1 tab per day